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NPI Code Detail

MEDICARE: DR. GARY K SHEN M.D.

MEDICARE: DR. GARY K SHEN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1204F00000XTransplant Surgery Physician9317NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1V52007OTHERNVPTAN
2CS09763OTHERNVPHARMACY/CDS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013995737
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GARY K SHEN M.D.
Provider Business Mailing Address
First Line : PO BOX 516588
Second Line :
City : LOS ANGELES
State : CA
Zip : 90051-0598
Country : US
Telephone Number : 702-671-6406
Fax Number : 702-895-4014
Provider Business Practice Location Address
First Line : 1707 W CHARLESTON BLVD STE 160
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-2354
Country : US
Telephone Number : 702-671-5150
Fax Number : 702-384-6493
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2006
Last Update Date : 03/07/2023

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